It may surprise you that Martha’s Vineyard is considered a “level two rural community,” an important distinction shared with only 20 percent of the nation. How can our bustling community be considered “rural” when we suffer mile-long traffic snarls near the roundabout and struggle to find a parking space at the Stop & Shop? Why does a “rural” designation matter anyway?
Higher than level one and short of a “frontier” designation, it means that we are geographically isolated from urban centers and lack a dense population. It matters, in part, because people living in rurally designated areas can face barriers to accessing high quality medical and dental care. They may need to travel greater distances or endure longer wait times to see a provider. Lack of care coordination may diminish the effectiveness of treatments. Patients may lack confidence they will receive quality care, lack trust that their privacy won’t be violated, or have health or dental insurance that isn’t accepted by the provider. These, among other factors, can lead patients to postpone getting needed health care, which can result in poor health outcomes.
Rural areas face healthcare workforce shortages and, in the Vineyard’s case, compounding housing shortages which restrict the supply of services and reduce the amount of primary care doctors available. Our hospital and health clinics work hard to attract and retain providers because primary care is vital to disease prevention and early detection — keys to keeping our community healthy. With impeded access to services, health issues that emerge individually or within the population can cause greater problems later on.
The federal government assists rural areas by using population statistics to direct funding to areas where it will have the greatest impact. They help finance housing, agriculture, transportation, education, health care; 320 programs in all, according to a report from the George Washington Institute of Public Policy: bit.ly/DCHC_GWI. The Census Bureau and the Office of Management and Budget provide the statistics which help to define what “rural” really is. You may remember the 2020 census count, and the tenacity of census agents as they worked to ensure that no one was missed. Because our community relies on the durability of government funding, it’s always in the best interests of anyone living in rural America to make sure they’re counted.
Many of the agencies serving the Vineyard rely upon benefits stemming from our rural designation. Island Health Care (IHC) is among them. It is Massachusetts’ first and only federally qualified rural health clinic, addressing the health care needs of 25 percent of our Island’s population, regardless of their ability to pay. During their 18 years of operation, IHC has grown their services based on the needs of our community. Due to an escalating urgency for dental care, their newest expansion will inaugurate a dental clinic through IHC’s partnership with Boston University’s Henry M. Goldman School of Dental Medicine. Together, they are developing an integrated model of primary care that will include oral health. When IHC’s dental clinic is operational, care will be provided by a team of full-time members of the faculty, students, and residents from Boston University.
Dental health, with its high cost and limited insurance reimbursements, is often one of the first things that we neglect when trying to minimize expenses. Many Island residents, particularly those who are lower income and reliant upon MassHealth, have difficulty accessing a dentist. Currently, MassHealth patients must travel off-Island and experience long wait times to receive care from a limited number of providers. Unfortunately, good dental care is not something we can scrimp on because of mounting evidence linking it with our physical health.
Some researchers believe that the bacteria causing gingivitis and periodontitis can travel through the bloodstream and create inflammation that will harm the heart and brain. A 2018 cohort study of 1 million people determined a positive association between tooth loss and coronary heart disease in both men and women. Correlations have also been shown between poor oral health and diabetes, kidney disease, rheumatoid arthritis, and new evidence suggests it can increase the risk of premature birth among pregnant women.
What better way to recognize Oral Health Month, which comes around each March, than to applaud Island Health Care for understanding our community’s health needs and investing the time and resources into making the Island a healthier place to live. We’re looking forward to hearing more about the dental clinic, and will keep our readers posted as an opening date nears. In the meantime, happy spring, everyone, and keep brushing!